• Title/Summary/Keyword: Purpura thrombocytopenic idiopathic

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A Case Report of the Herbal Medication Treatment and Counseling Therapy for the Chronic Idiopathic thrombocytopenic purpura Patient (사려과다(思慮過多)로 위한 비기허(脾氣虛)로 변증치료한 만성 특발성 혈소판감소증 1례)

  • Lee, Je-Kyun;Kim, Ji-Hyung;Ryu, Ki-Jun;Kwon, Seung-Ro;Lim, Myung-Jang;Kang, Man-Ho;Kim, Ha-Neul;An, Keon-Sang
    • Journal of Oriental Neuropsychiatry
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    • v.18 no.2
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    • pp.143-151
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    • 2007
  • This study report the good reslut for chronic Idiopathic thrombocytopenic purpura(ITP) patient with Herbal medication treatment and Counseling therapy. The case was a 56 years old female who worried about small matters too much. This patient treated in western medicine, However, didn't see any improvement. So, the patient admitted in our hospital. We diagnosied this patient as 'The Defiency of the Spleen energy', caused by too much thinking and concern. Herbal medication(Nokyonggunbitang)and psychotherapy applied to this patient for hospitalized 22 days. The result showed that blood platelet increased at discharged moment(37,000 / ${\mu}{\ell}$) compared with the admission time(19,000 / ${\mu}{\ell}$). The present result indicated that Herbal medication treatment and psychotherapy may play a role elevate and maintain the number of blood platelet.

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A 22-month-old Boy with Acute Glomerulonephritis Coexistent with Hemolytic Anemia and Idiopathic Thrombocytopenia

  • Park, Hye Won;Seo, Bo Seon;Jung, Su Jin;Lee, Jun Ho
    • Childhood Kidney Diseases
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    • v.19 no.1
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    • pp.43-47
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    • 2015
  • Hemolytic anemia and thrombocytopenia are rare clinical manifestations of acute glomerulonephritis. Initially, in all such cases, a diagnosis of hemolytic uremic syndrome, thrombotic thrombocytopenic purpura, systemic lupus erythematosus, and amyloidosis should be ruled out. The presence of hemolytic anemia and thrombocytopenia is rare, but possible, in a case of acute poststreptococcal glomerulonephritis, and may result in delayed diagnosis or misdiagnosis. Correct and timely diagnosis would ensure adequate treatment in such patients. We report of a 22-month-old boy with acute glomerulonephritis coexistent with hemolytic anemia and idiopathic thrombocytopenia.

Delayed treatment-free response after romiplostim discontinuation in pediatric chronic immune thrombocytopenia

  • Lim, Hyun Ji;Lim, Young Tae;Hah, Jeong Ok;Lee, Jae Min
    • Journal of Yeungnam Medical Science
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    • v.38 no.2
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    • pp.165-168
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    • 2021
  • We report the case of a 16-month-old patient with chronic immune thrombocytopenia (ITP) patient who experienced delayed treatment-free response (TFR) after romiplostim treatment. He received intravenous immunoglobulin every month to maintain a platelet count above 20,000/µL for 2 years. Thereafter, he received rituximab and cyclosporine as second-line therapy, with no response, followed by romiplostim. After 4 weeks of treatment, the platelet count was maintained above 50,000/µL. Following 7 months of treatment, he discontinued romiplostim, and the platelet count decreased. His platelet counts remained above 50,000/µL, without any bleeding symptoms, 2 years after romiplostim discontinuation. This is the first report of TFR after romiplostim treatment in pediatric chronic ITP.

Pediatric Laparoscopic Splenectomy (소아의 복강경하 비장절제술)

  • Kim, Won-Woo;Kim, Eung-Kook;Song, Young-Tack
    • Advances in pediatric surgery
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    • v.5 no.1
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    • pp.53-57
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    • 1999
  • Pediatric laparoscopic splenectomy has been gradually accepted as the surgical management of a various splenic disorders, particularly in hematologic diseases. We report our experience with 16 patients who underwent this procedure because of hematologic disorders during the past 3 and a half years at the Department of Surgery, St. Mary's Hospital, the Catholic University Medical College. The mean age was 10 years(range 6-16 years) and the mean spleen weight was 210 gm(range 85-500 g). The indication for splenectomy were hereditary spherocytosis(6 cases), idiopathic thrombocytopenic purpura(8 cases), autoimmune hemolytic anemia(1 case), and idiopathic splenomegaly(1 case). All splenectomies were performed safely with mean estimated blood loss of 233 ml. Mean operative time and mean postoperative hospital stay were 157 min and 4.5 days, respectively. Postoperative pain, medication was needed in 3 cases, just one injection in immediate postoperative period. Diet was started on the second or third postoperative day. In conclusion, laparoscopic splenectomy in pediatric patients is a safe procedure, offering a small of abdominal scar, much less pain, a shorter hospital stay and car the lower postoperative morbidity.

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Changes in Mean Platelet Volume and Platelet Distribution Width after Therapy in Childhood Idiopathic Thrombocytopenic Purpura (소아 특발성 혈소판 감소성 자반증 환아에서 치료경과에 따른 평균 혈소판용적과 혈소판용적 분포폭의 변동)

  • Kim, Jong Tai;Lee, Kyung Won;Kim, Soon Nam;Kim, Moon Kyu
    • Clinical and Experimental Pediatrics
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    • v.45 no.4
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    • pp.505-511
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    • 2002
  • Purpose : Mean platelet volume(MPV) and platelet distribution width(PDW) are useful parameters in evaluating disorders of platelets. In cases with idiopathic thrombocytopenic purpura(ITP), they change as platelet count increases. In this study, we compared the values of MPV and PDW in ITP patients at diagnosis with those of normal children. We also studied whether the early changes in MPV may predict the clinical course. Methods : From December 1995 to May 2001, 71 patients with ITP were admitted to Ajou University Hospital. They were treated with IVIg 400 mg/kg for five days and MPV, PDW, platelet count were analysed. Normal control group(n=38) was compared. The study group was divided into acute and chronic forms, and also divided into group A, good early responders whose platelets increased more than $100,000/{\mu}L$ within 5 days and group B who did not. Results : Mean value of MPV at diagnosis in ITP patients was lower than the normal control group(P<0.05). In group A, MPV was abruptly increased on the first day after IVIg and then started to decrease. But in group B, MPV was steadily increased until the fourth day after IVIg. In the normal control group, there were inverse correlations between platelet count and MPV(r=-0.415, P<0.05), but in ITP patients, there were positive relationships between platelet count and MPV(r=0.646, P<0.05) at diagnosis. Conclusions : MPV at diagnosis of ITP was lower than the normal control. MPV and PDW could not predict the course of ITP patients, but MPV could distinguish good early responders. More research is needed to find out the reasons of decreased MPV at diagnosis of ITP.

Prevalence and clinical significance of the positive antinuclear antibody in children with idiopathic thrombocytopenic purpura (소아 특발혈소판감소 자색반병 환자에서 항핵항체 검사의 양성률 및 임상적 의의)

  • Jun, So Eun;Park, Seong Sik;Lim, Young Tak
    • Clinical and Experimental Pediatrics
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    • v.51 no.11
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    • pp.1217-1221
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    • 2008
  • Purpose : An association between idiopathic thrombocytopenic purpura (ITP) and systemic lupus erythematosus (SLE) has been recognized for decades because thrombocytopenia is the first manifestation in some patients with SLE. However, the risk of later development of SLE in childhood ITP is currently unknown. We retrospectively evaluated the incidence and clinical significance of the positive antinuclear antibody (ANA) in children with acute ITP. Methods : This study was retrospectively performed to review the clinical and laboratory characteristics in 77 children diagnosed to have acute ITP and admitted to the Pusan National University Hospital between January 2003 and December 2006. Patients tested positive for ANA were regularly followed-up for at least 12 months for symptoms indicative of SLE. Results : Seventy-seven children were included in the study; 38 males (49.4%) and 39 females (50.5%), the mean age was 4.5 years. Sixteen (20.8%) ITP patients had a positive ANA, with a median titer of 1:320. The mean age of the patients with positive ANA was 9.3 years, which is much older than 3.3 years for patients with negative ANA (P<0.05). The positive ANA group was predominantly female (81.3%) compared to the negative ANA group (P<0.05). There was no statistically significant difference in mean platelet counts between both groups. No statistically significant difference was found in ANA positivity and progression to chronic ITP or SLE. After the median follow-up of 32 months, SLE was diagnosed only in one ITP patient with positive ANA. Conclusion : Our data demonstrated that ANA positivity is often found in children with acute ITP. Large-scale studies should be considered to determine the significance of ANA positivity in childhood ITP for the later development of SLE.

Indication of Bone Marrow Aspiration in Acute Idiopathic Thrombocytopenic Purpura in Children (소아 급성 특발성 혈소판 감소성 자반증에서 골수흡인 검사의 적응)

  • Kim, Won-Duck;Hah, Jeong-Ok
    • Journal of Yeungnam Medical Science
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    • v.18 no.2
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    • pp.239-245
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    • 2001
  • Background: Acute idiopathic thrombocytopenic purpura(ITF) is one of the common hematologic disorders in children. Bone marrow aspiration (BMA) is often performed in children with acute ITP to rule out leukemia, aplastic anemia or other hematologic diseases. However, whether BMA is needed in children with typical clinical and hematological features of acute ITP have been questioned. This study was performed to examine the proper indication of BMA in acute childhood ITF. Materials and Methods: The medical records and BMA reports of children with the provisional diagnosis of acute ITP were reviewed from January 1984 to December 2000. Patients were divided into two groups, one with typical and another with atypical clinical and hematological features of acute ITP. Typical acute ITP group was characterized by the history of previous viral infection, well being appearance, no hepatosplenomegaly, no lymphadenopathy, normal Hb, WEC, neutrophil count and peripheral blood smear except thrombocytopenia. A platelet count of $50{\times}l0^9/L$ or lower was the cutoff level. Results: Total 120 children with the provisional diagnosis of acute ITP were included. One hundred eighteen of them were confirmed to have acute ITP by BMAs. Of these, 66 had typical and 54 had atypical features. All of typical features and 52 of 54 with atypical features of acute ITP were confirmed to have acute ITP by BMAs. Two patients with atypical features of acute ITP were diagnosed as aplastic anemia and myelodyspalstic syndrome, respectively, by BMAs. Conclusion: This study concludes that BMA is not needed for the children with typical features of acute ITP but it is needed for the children with atypical features of acute ITP to rule out other hematologic disorders.

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Clinical Report on the Patients Suffering from Neurogenical Bladder (신경인성 방광 환자 치험 2례)

  • Yu, Byeong-Chan;Han, Yeong-Ju;Chae, Eun-Yeong;Yun, Dam-Hee;Lee, Nam-Hun;Cho, Chung-Sik;Kim, Chul-Jung;Lee, Ji-Yeong
    • The Journal of Internal Korean Medicine
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    • v.25 no.3
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    • pp.677-683
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    • 2004
  • The following case studies illustrate the application of oriental medical treatment of patients diagnosed with neurogenical bladder. The outstanding symptoms of two cases were general weakening and voiding difficulty, urinary retention and lack of urine sense. In one case, neurogenical bladder was caused by an operation on the femur, and in the other case, by diabetes and anemia. Western medical treatment didnot have any effect in these cases, but after oriental medical treatment, self-voiding was possible. These resu1t suggest that oriental treatment should be considered for patients with neurogenical bladder.

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A Case report of ascites in Liver cirrhosis treated with Taeumjowetang-gamibang (태음조위탕가미방(太陰調胃湯加味方)으로 복수를 동반한 간경변 환자 치험 1례)

  • Kim, Jung-Chul;Lee, Hae-Yeon;Park, Jung-Han;Lee, Jae-Jun;Lee, You-Kyung;Han, Dong-Youn;Cho, Hyun-Seok
    • The Journal of Internal Korean Medicine
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    • v.25 no.3
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    • pp.625-632
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    • 2004
  • Liver cirrhosis is a disease of the liver in which normal cells are replaced by scar tissue. This condition results in the failure of the liver to perform many of its usual functions. Liver cirrhosis include acsites, jaundice, portal hypertension, varices etc. This report is about one case of ascites with liver cirrhosis. In this case, we administrated Taeumjowetang-gamibang was administered and acupuncture was done in treatment of ascites and its symptoms. After administration of Taeumjowetang-gamibang medication, clinical symptoms and prominently improved and ascites dwindled to nothing. This reports suggests Taeumjowetang-gamibang has desirable effected on ascites.

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A Case of Evans Syndrome Treated through Oriental Medicine (한방적 치료 접근을 통한 Evans 증후군 치험 1례)

  • Park, Sang-Eun;Choi, In-Sun;Jang, Ja-Won;Hong, Sang-Hoon;Seo, Sang-Ho
    • The Journal of Internal Korean Medicine
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    • v.25 no.3
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    • pp.573-581
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    • 2004
  • Evans syndrome, as originally described, refers to autoimmune hemolytic anemia accompanied by thrombocytopenia. The autoantibodies in Evans syndrome are directed specifically against red cells, platelets, or neutrophils and are not crossreacting. The incidence of autoimmune hemolytic anemia is estimated to be approximately 10 cases per million people. Many patients have associated disorders, such as lupus erythematosus and other autoimmune disease, chronic lymphadenopathy, or hypogammaglobulinemia. In Oriental Medicine, the approach to Evans syndrome is made in view of deficiency of blood. The ailment was treated through methods of Oriental Medicine. Acupucture and herbal medicine were administered to patients diagnosed with Evans Syndrome by ecchymosis at the lower limb after continued gingival bleeding. As a result significant improvement in RBC, Hb, Hct, and PLT were observed and complaints abated.

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